THE EFFECTS OF VIRTUAL REALITY TRAINING ON BALANCE AND SPEED-AGILITY IN OBESE CHILDREN: A RANDOMIZED CONTROLLED TRIAL

Year 2024, Volume: 35 Issue: 1, 45 - 55, 20.04.2024

Hayriye Tomaç , Emine Handan Tüzün , Levent Eker

https://doi.org/10.21653/tjpr.1237822

Abstract

Purpose: The aim of the study was to examine the effects of virtual reality training on balance and speed-agility in obese children.
Methods: The study included 34 obese children at the ages of 9-11. Participants were divided into training and control groups using the simple randomization method. The participants in the intervention group (n=17) were taken into virtual reality training for 6 weeks. No treatment was applied on the control group (n=17). Balance was assessed by the Flamingo and Y balance tests. Speed-agility was assessed by the Bruininks-Oseretsky Test of Motor Proficiency-Brief Form-speed-agility sub-test. The physical activity enjoyment levels of the children in intervention group were assessed by the Short Form-Physical Activity Enjoyment Scale.
Results: Before the study, the groups were similar in terms of the investigated variables (p>0.05). Speed-agility scores and Y balance test anterior, posterior-lateral and mixed reaching distances of the children in intervention group significantly increased after the training in comparison to their pre-training results (p<0.05). While the Flamingo balance test results significantly increased from pretraining to post-training (p=0.001), considering along with the 95% CI, the increase was found to be insignificant (-0.42—7.42). In intervention group, except for the Y balance test anterior and posteriormedial reaching distances, static and dynamic balance and speed-agility clinical effects were large (r≥0.5). All participants in intervention group stated that they enjoyed virtual reality training to the highest degree (95% CI:25.0 —25.0).
Conclusion: Virtual reality training in obese children is effective in improvement of balance and speedagility, and it is an enjoyable option of physical activity. The large randomized controlled studies with long-term trainings and follow-up are recommended.

Keywords

postural balance , child , obesity , therapeutics , virtual reality

Project Number

ETK00-2017-0040

SANAL GERÇEKLİK EĞİTİMİNİN OBEZ ÇOCUKLARDA DENGE VE HIZ-ÇEVİKLİK ÜZERİNDEKİ ETKİLERİ: RANDOMİZE KONTROLLÜ ÇALIŞMA

Abstract

Amaç: Çalışmanın amacı, obez çocuklarda sanal gerçeklik eğitiminin denge ve hız-çeviklik üzerindeki etkilerini incelemektir.
Yöntemler: Çalışmaya 9-11 yaşlarında 34 obez çocuk dahil edildi. Katılımcılar basit randomizasyon yöntemi ile eğitim ve kontrol grubuna ayrıldı. Eğitim grubundaki katılımcılar (n=17) 6 hafta boyunca sanal gerçeklik eğitimine alındı. Kontrol grubuna (n=17) herhangi bir tedavi uygulanmadı. Denge, Flamingo ve Y denge testleri ile değerlendirildi. Hız-çeviklik Bruininks-Oseretsky Motor Yeterlilik TestiKısa Form-hız çeviklik alt testi ile değerlendirildi. Eğitim grubundaki çocukların fiziksel aktiviteden keyif alma düzeyleri Kısa Form-Fiziksel Aktiviteden Keyif Alma Ölçeği ile değerlendirildi.
Bulgular: Çalışma öncesinde, gruplar incelenen değişkenler açısından benzerdi (p>0,05). Eğitim grubundaki çocukların sürat-çeviklik skorları ve Y denge testi ön, arka-yan ve karışık uzanma mesafeleri eğitim sonrasında eğitim öncesine göre anlamlı olarak arttı (p<0,05). Flamingo denge testi sonuçları eğitim öncesinden eğitim sonrasına anlamlı olarak artarken (p=0,001), %95 GA ile birlikte değerlendirildiğinde artışın önemsiz olduğu görüldü (-0,42-7,42). Eğitim grubunda, Y denge testi anterior ve posterior-medial uzanma mesafeleri dışında, statik ve dinamik denge ve hız-çeviklik klinik etkileri büyüktü (r≥0,5). Eğitim grubundaki tüm katılımcılar sanal gerçeklik eğitiminden en yüksek derecede keyif aldıklarını belirtti. (%95 CI:25,0 -25,0).
Sonuç: Obez çocuklarda sanal gerçeklik eğitimi denge ve hız-çeviklik gelişiminde etkilidir ve fiziksel aktivite için eğlenceli bir seçenektir. Uzun süreli eğitim ve takip içeren geniş randomize kontrollü çalışmalar önerilmektedir.

Keywords

ÇOCUK , postural denge , terapötik , obezite , sanal gerçeklik

Supporting Institution

Doğu Akdeniz Üniversitesi

Project Number

ETK00-2017-0040

References

• World Health Organization Obesity and Overweight. 2023; http://www.who.int/mediacentre/factsheets/fs311/en/ Accessed 05 March 2023.
• World Health Regıonal Obesity Report 2022; https://apps.who.int/iris/bitstream/handle/10665/353747/9789289057738-eng.pdf, Accessed 04 March 2023.
• Savva, S.C., Kouridesa, Y.A., Hadjigeorgioua, C., Tornaritis, M.J. (2014). Overweight and obesity prevalence and trends in children and adolescents in Cyprus 2000—2010. Obes Res Clin Pract. 8(5):426-434. https://doi.org/10.1016/j.orcp.2013.11.005.
• Zhang, L. Yan, S., Li, R., Dan, W., Yang, L. (2022). Does weight loss affect the center of pressure of children with obesity: A follow-up study. Journal of Leather Science and Engineering. 4(1):9. https://doi.org/10.1186/s42825-022-00083-6.
• Boucher, F., Handrigan, G.A., Mackrous, I., Hue, O. (2015). Childhood obesity affects postural control and aiming performance during an upper limb movement. Gait Posture. 42(2):116-121. https://doi.org/10.1016/j.gaitpost.2015.04.016.
• Steinberg, N., Nemet, D., Pantanowitz, M., Eliakim, A. (2018). Gait Pattern, Impact to the Skeleton and Postural Balance in Overweight and Obese Children: A Review. Sports (Basel). 6(3):75. https://doi:10.3390/sports6030075.
• Meng, H., O’Connor, D.P., Lee, B.C., Layne, C.S., Gorniak, S.L. (2016). Effects of adiposity on postural control and cognition. Gait Posture. 43:31-37. https://doi.org/10.1016/j.gaitpost.2015.10.012.
• Wyszyńska, J., Ring-Dimitriou, S., Thivel, D., et al. (2020). Physical Activity in the Prevention of Childhood Obesity: The Position of the European Childhood Obesity Group and the European Academy of Pediatrics. Front Pediatr. 8:535-705. https://doi:10.3389/fped.2020.535705.
• Giménez Garcia-Conde, M., Marin, L., Ruiz de Maya, S., & Cuestas, P. J. (2020). Parental Attitudes to Childhood Overweight: The Multiple Paths through Healthy Eating, Screen Use, and Sleeping Time. International Journal of Environmental Research and Public Health, 17(21), 7885.
• Zoghby, H. B., Sfeir, E., Akel, M., Malaeb, D., Obeid, S., Hallit, S. (2022). Knowledge, attitude and practice of Lebanese parents towards childhood overweight/obesity: the role of parent-physician communication. BMC pediatrics, 22(1), 209.
• Howard, Matt, C., (2017). "A meta-analysis and systematic literature review of virtual reality rehabilitation programs." Computers in Human Behavior. 70:317-327.
• Zeng, N., Gao, Z. (2016). Exergaming and obesity in youth: current perspectives. International journal of general medicine. 275-284.
• World Health Organization, (2007), BMI for Age (5-19 years), http://www.who.int/growthref/who2007_bmi_for_age/en/ (6 Eylül 2016).
• Sheehan, D.P., Katz, L. (2013). The effects of a daily, 6-week exergaming curriculum on balance in fourth grade children. J Sport Health Sci. 2(3):131-137. https://doi.org/10.1016/j.jshs.2013.02.002.
• Lisón, J.F., Cebolla, A., Guixeres, J., Alvarez-Pitti, J., et al. (2015). Competitive active video games: Physiological and psychological responses in children and adolescents. Paediatrics and child health. 20(7):373-376.
• Arsalan, M., Aydemir, I., Ayhan, N. Y. (2021). Examination of The Relationship Between Depression and Body Mass Index (BMI) Among University Students. Clinical and Experimental Health Sciences. 11(1):175-181.
• Imamoglu, M., Sener, O. A. (2019). Comparison of Children's Motor Performances by Age and Gender. Universal Journal of Educational Research. 7(1):10-15.
• Sember, V., Grošelj, J., Pajek, M. (2020). Balance tests in pre-adolescent children: Retest reliability, construct validity, and relative ability. International journal of environmental research and public health, 17(15), 5474.
• Yam, T.T.T., Fong, S.S.M. (2019). Y-balance test performance and leg muscle activations of children with developmental coordination disorder. Journal of Motor Behavior. 51(4):385-393. https://doi.org/10.1080/00222895.2018.1485011.
• Faigenbaum, A. D., Myer, G. D., Fernandez, I. P., Carrasco, E. G., Bates, N., Farrell, A., ... & Kang, J. (2014). Feasibility and reliability of dynamic postural control measures in children in first through fifth grades. International journal of sports physical therapy, 9(2), 140.
• Köse, B., Şahin, S., Karabulut, E., Kayıhan, H. (2021). Turkish version of bruininks-oseretsky test of motor proficiency 2 brief form: Its validity and reliability in children with specific learning disability.
• Mirzeoğlu, A.D., Çoknaz, D. A. (2014). validity and reliability study of physical activity enjoyment scale short form for Turkish children and youth. JHS. 11(1):672-687. https://doi.org/10.14687/ijhs.v11i1.2794.
• Knezevic, A. (2008). Overlapping confidence intervals and statistical significance, Cornell University. StatNews 73. https://cscu.cornell.edu/news/statnews/stnews73.pdf. Accessed 15 February 2017.
• Rosenthal, R. Parametric measures of effect size. In: Cooper, H., Hedges, L.V., Valentine, J.C. (eds) (1994). The handbook of research synthesis, Russell Sage Foundation, New York. pp. 231-244.
• Hur, P., Pan, Y.T., DeBuys, C. (2019). Free energy principle in human postural control system: Skin stretch feedback reduces the entropy. Scientific Reports. 9(1):16870. https://doi.org/10.1038/s41598-019-53028-1.
• Wiesinger, H.P., Buchecker, M., Müller, E., Stöggl, T., Birklbauer, J. (2022). Decreased Postural Complexity in Overweight to Obese Children and Adolescents: A Cross-Sectional Study. Frontiers in Human Neuroscience. 16. https://doi.org/10.3389/fnhum.2022.850548.
• McGraw, B., McClenaghan, B.A., Williams, H.G., Dickerson, J. (2000). Gait and postural stability in obese and nonobese prepubertal boys. Arch Phys Med Rehabil. 81(4):484-489.
• Marinelli, E.C., Rogers, W.A. (2014). Identifying potential usability challenges for Xbox 360 Kinect exergames for older adults. Proc Hum Factors Ergon Soc Annu Meet. 58(1):1247-1251. https://doi.org/10.1177/1541931214581260.
• Beaulieu-Boire, L., Belzile-Lachapelle, S., Blanchette, A., et al. (2015). Balance rehabilitation using xbox kinect among an elderly population: a pilot study. J Nov Physiother. 5(2):261. https://doi.org/10.4172/2165-7025.1000261.
• Kang, M. H., Kim, G. M., Kwon, O. Y., Weon, J. H., Oh, J. S., An, D. H. (2015). Relationship between the kinematics of the trunk and lower extremity and performance on the Y-balance test. PM&R, 7(11), 1152-1158.
• Gabbard, C.P. (2008). Lifelong motor development. Benjamin-Cumings Publishing Co. 5th Ed: San Francisco.
• Van Biljon A, Longhurst G. (2012)The influence of exergaming on the functional fitness in overweight and obese children. Afr J Phys Act Health Sci. 18(4):991.
• Comeras-Chueca, C., Marin-Puyalto, J., Matute-Llorente, A., Vicente-Rodriguez, G., Casajus, J. A., Gonzalez-Aguero, A. (2021). Effects of active video games on health-related physical fitness and motor competence in children and adolescents with overweight or obesity: systematic review and meta-analysis. JMIR Serious Games, 9(4), e29981.
• Overmoyer GV, Reiser RF. (2015). Relationships between lower-extremity flexibility, asymmetries, and the Y balance test. J Strength Cond Res. 29(5):1240-7.
• Kang MH, Lee DK, Park KH, Oh JS. (2015). Association of ankle kinematics and performance on the y-balance test with inclinometer measurements on the weight-bearing-lunge test. J Sport Rehab. 24(1):62-7.
• Sheehan, D.P., Katz, L. (2012). The impact of a six week exergaming curriculum on balance with grade three school children using the Wii FIT+™. Int J Comput Sci Sport. 11(3):5-22.
• Papastergiou, M. (2009). Exploring the potential of computer and video games for health and physical education: A literature review. Comput Educ. 53(3):603–622. https://doi.org/10.1016/j.compedu.2009.04.001.
• Ausias Cebolla i Martí, Julio Carlos Álvarez-Pitti, Jaime Guixeres Provinciale, Juan Francisco Lisón, y Rosa Baños Rivera. (2015). Alternative options for prescribing physical activity among obese children and adolescents: brisk walking supported by an exergaming platform. Nutr Hosp. 31(2):841-848. https://doi.org/10.3305/nh.2015.31.2.7929